Development of a Brief Primary Care Intervention for PTSD in Adolescents

• Published in: Clinical practice in pediatric psychology 2022-03, Vol.10 (1), p.54-65
• Main Authors: Srivastava, Akanksha, Miller, Alexandria N., Coles, Mandy S., Brigham, Rebecca, Peterson, Erin R., Kreida, Ellen, Mueser, Kim T., Ng, Lauren C.
• Format: Article
• Language: English
• Subjects: Adolescent Development; Clinics; Education; Female; Human; Integrated Services; Intervention; Male; Posttraumatic Stress Disorder; Primary Health Care; Relaxation
• ISSN: 2169-4826; 2169-4834
• DOI: 10.1037/cpp0000382

Objective: Our study aimed to adapt an evidence-based, brief intervention for use in an urban safety net adolescent primary care center with an existing integrated behavioral health team who have not previously treated posttraumatic stress disorder (PTSD) explicitly in the clinic. PTSD is routinely undertreated in adolescent primary care due in part to a lack of evidence-based interventions for PTSD that can be feasibly delivered in primary care. Sustainable PTSD interventions in adolescent medicine clinics must overcome patient-, provider-, and system-level barriers. Method: The Brief Relaxation, Education And Trauma Healing (BREATHE) was selected for adaptation based on a literature review of evidence-based target interventions. Purposeful sampling was used to recruit nine adolescent patients, two parents, and eight clinic staff (N = 19) for individual qualitative interviews focused on feasibility of implementation of a PTSD intervention delivered in an adolescent medicine primary care clinic that serves diverse patients with high trauma exposure. Audio recordings from these interviews were transcribed and analyzed using inductive and directed a priori approaches related to the central research questions. Results: Participants provided feedback on the format and content of the BREATHE intervention to adapt the existing treatment to be feasible and sustainable in a primary care setting. Overall, participants thought the intervention was helpful and feasible and provided specific feedback for adaptation. Conclusion: This study developed the Primary Care Intervention for PTSD (PCIP) as a resource for improving PTSD care for adolescents in a primary care setting. Further studies will evaluate PCIP efficacy on PTSD symptomology. Implications for Impact Statement This study adapted a three-session intervention for posttraumatic stress disorder (PTSD) to be used in an adolescent primary care clinic. The Primary Care Intervention for PTSD is a resource that primary care clinics can implement into their practice as a feasible intervention for patients with PTSD.